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It is not by chance that the most recent clinical guidelines [10] continue to advocate the use of antidiabetic drugs that have been proven to reduce cardiovascular events and mortality

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Management If B Deficiency Is Confirmed Oral cyanocobalamin: 10002000 g daily or IM hydroxocobalamin: Loading: 1 mg weekly for 46 weeks Maintenance: 1 mg every 23 months Metformin should usually be continued Supplement B rather than stopping metformin 7